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Gasca-Salas C, Trompeta C, López-Aguirre M, Rodríguez Rojas R, Clarimon J, Dols-Icardo O, El Bounasri S, Guida P, Mata-Marín D, Hernández-Fernández F, Marras C, García-Cañamaque L, Plaza de Las Heras I, Obeso I, Vela L, Fernández-Rodríguez B. Brain hypometabolism in non-demented microtubule-associated protein tau H1 carriers with Parkinson's disease. J Neuroimaging 2023; 33:953-959. [PMID: 37726927 DOI: 10.1111/jon.13156] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 09/06/2023] [Accepted: 09/10/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND AND PURPOSE The microtubule-associated protein tau (MAPT) H1 homozygosity (H1/H1 haplotype) is a genetic risk factor for neurodegenerative diseases, such as Parkinson's disease (PD). MAPT H1 homozygosity has been associated with conversion to PD; however, results are conflicting since some studies did not find a strong influence. Cortical hypometabolism is associated with cognitive impairment in PD. In this study, we aimed to evaluate the metabolic pattern in nondemented PD patients MAPT H1/H1 carriers in comparison with MAPT H1/H2 haplotype. In addition, we evaluated domain-specific cognitive differences according to MAPT haplotype. METHODS We compared a group of 26 H1/H1 and 20 H1/H2 carriers with late-onset PD. Participants underwent a comprehensive neuropsychological cognitive evaluation and a [18F]-Fluorodeoxyglucose PET-MR scan. RESULTS MAPT H1/H1 carriers showed worse performance in the digit span forward test of attention compared to MAPT H1/H2 carriers. In the [18F]-Fluorodeoxyglucose PET comparisons, MAPT H1/H1 displayed hypometabolism in the frontal cortex, parahippocampal, and cingulate gyrus, as well as in the caudate and globus pallidus. CONCLUSION PD patients MAPT H1/H1 carriers without dementia exhibit relative hypometabolism in several cortical areas as well as in the basal ganglia, and worse performance in attention than MAPT H1/H2 carriers. Longitudinal studies should assess if lower scores in attention and dysfunction in these areas are predictors of dementia in MAPT H1/H1 homozygotes.
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Affiliation(s)
- Carmen Gasca-Salas
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
- Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain
- University CEU-San Pablo, Madrid, Spain
| | - Clara Trompeta
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
- PhD Program in Health Sciences, University of Alcala de Henares Alcalá de Henares, Madrid, Spain
| | - Miguel López-Aguirre
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
- Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain
- PhD Program in Physics, Complutense University of Madrid, Madrid, Spain
| | - Rafael Rodríguez Rojas
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
- Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain
| | - Jordi Clarimon
- Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain
- Memory Unit, Neurology Department and Sant Pau Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Oriol Dols-Icardo
- Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain
- Memory Unit, Neurology Department and Sant Pau Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Shaimaa El Bounasri
- Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain
- Memory Unit, Neurology Department and Sant Pau Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pasqualina Guida
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
- PhD Program in Neuroscience, Autónoma de Madrid University-Cajal Institute, Madrid, Spain
| | - David Mata-Marín
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
- PhD Program in Neuroscience, Autónoma de Madrid University-Cajal Institute, Madrid, Spain
| | - Frida Hernández-Fernández
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
- Department of Nursing and Nutrition, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Connie Marras
- The Edmond J Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Centre, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Lina García-Cañamaque
- Nuclear Medicine Department, PET-MRI Centre, HM Puerta del Sur University Hospital, HM Hospitales, Madrid, Spain
| | - Isabel Plaza de Las Heras
- Nuclear Medicine Department, PET-MRI Centre, HM Puerta del Sur University Hospital, HM Hospitales, Madrid, Spain
| | - Ignacio Obeso
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
- Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain
| | - Lydia Vela
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
- Department of Neurology, Hospital U Fundación Alcorcón, Calle Budapest, Alcorcón, Spain
| | - Beatriz Fernández-Rodríguez
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
- PhD Program in Neuroscience, Autónoma de Madrid University-Cajal Institute, Madrid, Spain
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López-Aguirre M, Matarazzo M, Blesa J, Monje MHG, Rodríguez-Rojas R, Sánchez-Ferro A, Obeso JA, Pineda-Pardo JA. Dopaminergic denervation and associated MRI microstructural changes in the nigrostriatal projection in early Parkinson's disease patients. NPJ Parkinsons Dis 2023; 9:144. [PMID: 37852988 PMCID: PMC10584921 DOI: 10.1038/s41531-023-00586-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 10/03/2023] [Indexed: 10/20/2023] Open
Abstract
Loss of dopaminergic neurons in the substantia nigra pars compacta (SNc) and a profound reduction of striatal dopamine are two hallmarks of Parkinson's disease (PD). However, it's unclear whether degeneration starts at the neuronal soma or the striatal presynaptic terminals, and how microstructural degeneration is linked to dopaminergic loss is also uncertain. In this study, thirty de novo PD patients and twenty healthy subjects (HS) underwent 6-[18F]-fluoro-L-dopa (FDOPA) PET and MRI studies no later than 12 months from clinical diagnosis. FDOPA uptake rate (Ki), fractional volume of free-water (FW), and iron-sensitive R2* relaxometry were quantified within nigrostriatal regions. Inter-group differences (PD vs HS) were studied using non-parametric statistics and complemented with Cohen's d effect sizes and Bayesian statistics. Correlation analyses were performed exploring biomarker dependencies and their association with bradykinesia scores. PD patients exhibited a significant decline in nigrostriatal dopaminergic activity, being post-commissural putamen (-67%) and posterolateral SNc (-11.7%) the most affected subregions within striatum and SNc respectively. Microstructural alterations (FW) were restricted to the hemisphere corresponding to the most affected side and followed similar spatial gradients as FDOPA Ki (+20% in posterior putamen and +11% in posterolateral SNc). R2* revealed no relevant significant changes. FDOPA and FW were correlated within the posterolateral SNc, and clinical severity was associated with FDOPA Ki loss. The asymmetry between striatal and SNc changes for both dopaminergic depletion and microstructural degeneration biomarkers is consistent with a neurodegenerative process that begins in the striatal terminals before progressing toward the cell bodies in the SNc.
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Affiliation(s)
- M López-Aguirre
- HM CINAC (Centro Integral de Neurociencias Abarca Campal). Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
- PhD Program in Physics, Complutense University of Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
- Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, 20815, USA
| | - M Matarazzo
- HM CINAC (Centro Integral de Neurociencias Abarca Campal). Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - J Blesa
- HM CINAC (Centro Integral de Neurociencias Abarca Campal). Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
- Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, 20815, USA
| | - M H G Monje
- HM CINAC (Centro Integral de Neurociencias Abarca Campal). Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
- Ken and Ruth Davee Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - R Rodríguez-Rojas
- HM CINAC (Centro Integral de Neurociencias Abarca Campal). Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - A Sánchez-Ferro
- HM CINAC (Centro Integral de Neurociencias Abarca Campal). Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
- Department of Neurology, University Hospital 12 de Octubre, Madrid, Spain
- Department of Medicine, Complutense University of Madrid, Madrid, Spain
| | - J A Obeso
- HM CINAC (Centro Integral de Neurociencias Abarca Campal). Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
- Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, 20815, USA
- University CEU-San Pablo, Madrid, Spain
| | - J A Pineda-Pardo
- HM CINAC (Centro Integral de Neurociencias Abarca Campal). Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain.
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain.
- Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, 20815, USA.
- University CEU-San Pablo, Madrid, Spain.
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Trompeta C, Gasca-Salas C, Pineda-Pardo JA, Guida P, Cohn M, Mata-Marín D, Monje MH, López-Aguirre M, Obeso I, Sánchez Ferro Á. Longitudinal assessment of social cognition in de novo Parkinson's disease patients and its relationship with dopaminergic innervation. Behav Brain Res 2023; 454:114654. [PMID: 37659457 DOI: 10.1016/j.bbr.2023.114654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 07/10/2023] [Accepted: 08/29/2023] [Indexed: 09/04/2023]
Abstract
BACKGROUND Social Cognition (SC) has been scarcely studied in Parkinson's disease (PD), and findings in early disease are controversial. SC encompasses different capacities such as facial emotion recognition (FER); Theory of Mind (ToM), the ability to understand other people's intentions (cognitive-ToM) and emotions (affective-ToM); and self-monitoring, the ability to regulate one's own behavior in social contexts. A relationship between dopaminergic deficit and SC in PD has been suggested. OBJECTIVES To prospectively assess, over a two-year period, SC in newly diagnosed drug-naïve, cognitively normal and non-depressed PD patients. Furthermore, we aimed to evaluate the relationship between SC and Fluorodopa (Positron Emission Tomography) Ki uptake, which is a marker of dopaminergic depletion. METHODS We compared SC performance between 25 de novo PD patients and 20 healthy controls (HC), and within-patients at baseline and two-year follow-up. The SC assessment included FER, ToM, as well as self-monitoring measures. The relationship between SC and dopaminergic innervation was also assessed in patients. RESULTS SC scores did not differ between PD and HC groups at baseline, nor between baseline and follow-up evaluation in PD. A significant positive correlation between self-monitoring and Fluorodopa Ki uptake in the left pallidum in PD patients was found at baseline. At follow-up, ToM (stories) positively correlated with Fluorodopa Ki uptake in the right thalamus and the left putamen. CONCLUSION SC appears to be preserved in de novo PD and remains stable in the short-term. Although more evidence is needed, our results support a relationship between dopamine innervation in subcortical regions and SC.
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Affiliation(s)
- Clara Trompeta
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales. Madrid, Spain; PhD Program in Health Sciences, University of Alcala de Henares Alcalá de Henares, Madrid 28054, Spain
| | - Carmen Gasca-Salas
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales. Madrid, Spain; Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain; University CEU-San Pablo, Madrid, Spain.
| | - José A Pineda-Pardo
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales. Madrid, Spain
| | - Pasqualina Guida
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales. Madrid, Spain; PhD Program in Neuroscience, Autónoma de Madrid University-Cajal Institute, Madrid 28029, Spain
| | | | - David Mata-Marín
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales. Madrid, Spain; PhD Program in Neuroscience, Autónoma de Madrid University-Cajal Institute, Madrid 28029, Spain
| | - Mariana Hg Monje
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales. Madrid, Spain
| | - Miguel López-Aguirre
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales. Madrid, Spain; PhD Program in Physics, Complutense University of Madrid, Madrid, Spain
| | - Ignacio Obeso
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales. Madrid, Spain; Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain
| | - Álvaro Sánchez Ferro
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales. Madrid, Spain
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4
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López-Aguirre M, Caballero-Insaurriaga J, Urso D, Rodríguez-Rojas R, Máñez-Miró JU, Del-Alamo M, Rachmilevitch I, Martínez-Fernández R, Pineda-Pardo JA. Lesion 3D modeling in transcranial MR-guided focused ultrasound thalamotomy. Magn Reson Imaging 2021; 80:71-80. [PMID: 33905832 DOI: 10.1016/j.mri.2021.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 04/08/2021] [Accepted: 04/21/2021] [Indexed: 01/21/2023]
Abstract
Transcranial magnetic resonance-guided focused ultrasound (tMRgFUS) allows to perform incisionless thermoablation of deep brain structures. This feature makes it a very useful tool for the treatment of multiple neurological and psychiatric disorders. Currently, feedback of the thermoablation process is based on peak temperature readings assessed on real-time two-dimensional MRI thermometry. However, an accurate methodology relating thermal dosimetry with three-dimensional topography and temporal evolution of the lesion is still to be defined, thus hurdling the establishment of well-defined, evidence-based criteria to perform safe and effective treatments. In here we propose threshold-based thermoablation models to predict the volumetric topography of the lesion (whole lesion and necrotic core) in the short-to-mid-term based on thermal dosimetry estimated from intra-treatment MRI thermometry. To define and validate our models we retrospectively analyzed the data of sixty-three tMRgFUS thalamotomies for treating tremor. We used intra-treatment MRI thermometry to estimate whole-treatment three-dimensional thermal dose maps, defined either as peak temperature reached (Tmax) or thermal isoeffective dose (TID). Those maps were thresholded to find the dosimetric level that maximize the agreement (Sorensen-Dice coefficient - SDc) with the boundaries of the whole lesion and its core, assessed on T2w images 1-day (post-24h) and 3-months (post-3M) after treatment. Best predictions were achieved for the whole lesion at post-24h (SDc = 0.71), with Tmax /TID over 50.0 °C/90.5 CEM43. The core at post-24h and whole lesion at post-3M lesions reported a similar behavior in terms of shape accuracy (SDc ~0.35), and thermal dose thresholds ~55 °C/4100.0 CEM43. Finally, the optimal levels for post-3M core lesions were 55.5 °C/5800.0 CEM43 (SDc = 0.21). These thermoablation models could contribute to the real-time decision-making process and improve the outcome of tMRgFUS interventions both in terms of safety and efficacy.
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Affiliation(s)
- Miguel López-Aguirre
- HM CINAC, Centro Integral de Neurociencias AC, Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain; Universidad Complutense de Madrid, Madrid, Spain
| | - Jaime Caballero-Insaurriaga
- HM CINAC, Centro Integral de Neurociencias AC, Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain; Universidad Politécnica de Madrid, Madrid, Spain
| | - Daniele Urso
- King's College (KCL), Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom
| | - Rafael Rodríguez-Rojas
- HM CINAC, Centro Integral de Neurociencias AC, Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain; Universidad San Pablo CEU, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas Instituto Carlos III, Madrid, Spain
| | - Jorge U Máñez-Miró
- HM CINAC, Centro Integral de Neurociencias AC, Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
| | - Marta Del-Alamo
- HM CINAC, Centro Integral de Neurociencias AC, Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
| | | | - Raúl Martínez-Fernández
- HM CINAC, Centro Integral de Neurociencias AC, Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain; Universidad San Pablo CEU, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas Instituto Carlos III, Madrid, Spain
| | - José A Pineda-Pardo
- HM CINAC, Centro Integral de Neurociencias AC, Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain; Universidad San Pablo CEU, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas Instituto Carlos III, Madrid, Spain.
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Pineda-Pardo JA, Máñez-Miró JU, López-Aguirre M, Rodríguez-Rojas R, Caballero-Insaurriaga J, M DÁ, Martínez-Fernández R, Obeso JA. Letter: The Role of Skull Thickness Beyond the Skull Density Ratio on MRgFUS Thalamotomy Feasibility: Which Patients Should We Exclude? Neurosurgery 2020; 86:E477-E479. [PMID: 31943090 DOI: 10.1093/neuros/nyz566] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- José A Pineda-Pardo
- Centro Integral de Neurociencias (HM-CINAC) Hospital Universitario HM Puerta del Sur Fundación de Investigación HM Hospitales Madrid, Spain.,Universidad San Pablo CEU Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas Instituto Carlos III Madrid, Spain
| | - Jorge U Máñez-Miró
- Centro Integral de Neurociencias (HM-CINAC) Hospital Universitario HM Puerta del Sur Fundación de Investigación HM Hospitales Madrid, Spain
| | - Miguel López-Aguirre
- Centro Integral de Neurociencias (HM-CINAC) Hospital Universitario HM Puerta del Sur Fundación de Investigación HM Hospitales Madrid, Spain
| | - Rafael Rodríguez-Rojas
- Centro Integral de Neurociencias (HM-CINAC) Hospital Universitario HM Puerta del Sur Fundación de Investigación HM Hospitales Madrid, Spain.,Universidad San Pablo CEU Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas Instituto Carlos III Madrid, Spain
| | - Jaime Caballero-Insaurriaga
- Centro Integral de Neurociencias (HM-CINAC) Hospital Universitario HM Puerta del Sur Fundación de Investigación HM Hospitales Madrid, Spain
| | - Del Álamo M
- Centro Integral de Neurociencias (HM-CINAC) Hospital Universitario HM Puerta del Sur Fundación de Investigación HM Hospitales Madrid, Spain
| | - Raúl Martínez-Fernández
- Centro Integral de Neurociencias (HM-CINAC) Hospital Universitario HM Puerta del Sur Fundación de Investigación HM Hospitales Madrid, Spain.,Universidad San Pablo CEU Madrid, Spain
| | - José A Obeso
- Centro Integral de Neurociencias (HM-CINAC) Hospital Universitario HM Puerta del Sur Fundación de Investigación HM Hospitales Madrid, Spain.,Universidad San Pablo CEU Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas Instituto Carlos III Madrid, Spain
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